bioRxiv preprint doi: https://doi.org/10.1101/2020.03.14.988758; this version posted March 15, 2020. The copyright holder for this preprint (which was not certified by peer review) is the author/funder. All rights reserved. No reuse allowed without permission. Self-antigen driven affinity maturation is required for pathogenic monovalent IgG4 autoantibody development Miriam L. Fichtner1,2,*, Casey Vieni3,4,*, Rachel L. Redler3, Ljuvica Kolich3, Ruoyi Jiang2, Kazushiro Takata1,2, Panos Stathopoulos1,2, Pablo Suarez1,2, Richard J. Nowak1, Steven J. Burden3, Damian C. Ekiert3,§ and Kevin C. O’Connor1,2,§. 1. Department of Neurology, Yale University School of Medicine, New Haven, CT 06511, USA 2. Department of Immunobiology, Yale University School of Medicine, New Haven, CT 06511, USA 3. Departments of Cell Biology and Microbiology, New York University School of Medicine, New York, NY 10016, USA 4. Medical Scientist Training Program, New York University School of Medicine, New York, NY, USA *, § Authorship note: First authors MLF and CV, and senior authors DCE and KCO contributed equally to this work. Corresponding author and contact information: Kevin C. O’Connor, PhD Yale School of Medicine Departments of Neurology and Immunobiology 300 George Street - Room 353J New Haven, CT 06511 Phone: (203)-737-3321 Fax: (203)-737-7903
[email protected] bioRxiv preprint doi: https://doi.org/10.1101/2020.03.14.988758; this version posted March 15, 2020. The copyright holder for this preprint (which was not certified by peer review) is the author/funder. All rights reserved. No reuse allowed without permission. Summary IgG4 autoantibodies in autoimmune myasthenia gravis are functionally monovalent, requiring a high affinity threshold featuring fast on/slow off rates, to reach pathogenic capacity.